System dynamics analysis of sugar-sweetened beverage taxing effect on sugar consumption, dental health service utilization and oral health for Thai adults and elderly

Abstract

Dental caries is a major oral health problem, particularly among developing countries. Almost half of Thai adults and elderly have at least one untreated dental caries. Dental caries can result in debilitating pain that affects work productivity and even the performance of daily activities. The objectives of this study are to develop system dynamics model addressing the relationship of dental caries, sugar consumption and dental health service utilization of Thai population aged 15 and older; and to estimate the changes of dental caries prevalence when the sugar-sweetened beverage tax is implemented. A multi-sector system dynamics model was developed to consolidate the relationship between the progression of dental caries experience and oral health related behaviors. Four hypothetical policy scenarios were simulated to investigate potential points of intervention to improve dental caries status in the population. The main scenario was the implementation of sugar-sweetened beverage tax. The study shows that the sugar-sweetened beverage tax can produce the reduction of sugar consumption compared to the base-case scenario without the policy for both short-run (3.2% for poverty population, and 5.4% for non-poverty population) and long-run (5.2% for poverty population, and 7.5% for non-poverty population). However, the impact of the sugar-sweetened beverage tax on reduction of dental caries prevalence is not pronounced. The model also shows that the combined tax policy with other non-tariff intervention such as health promotion program and the encouragement of reformulation in sugar-sweetened beverages could provide the most benefit on reduction of sugar consumption and dental caries prevalence. In addition, changes in oral health are evident in populations at high risk for dental caries. This study is an example of system dynamics model use for providing policy makers with additional insights to support their oral health policy planning for Thai population.